Abstract

When therapists research clinical populations or situations from a
qualitative research perspective, their task is different from when
researchers conduct their own clinical qualitative studies. With
researchers, the study at hand may be their first time "in the field." For
researchers in this situation it is easier to use qualitative methods such
as grounded theory (Glaser & Strauss,
1967) because there is a "tabula rasa" quality to this initial foray into
the "unknown" as a theory from observations is constructed anew. In the
case of the therapists-as-qualitative-researchers, clinicians already have
made some sort of sense of "the other" by virtue of their previous
experiences or exposures with the population or situation in question.
Instead of constructing theories like their researcher colleagues,
researching clinicians must face their previous constructions (i.e.,
sensemaking from experience), create methods which allow for
deconstruction (i.e., sensemaking challenged), and then work towards
building reconstructions (i.e., sensemaking remade) (Dervin, 1992; Duffy, 1995; Shields & Dervin, 1993; Weick, 1995). In this manner, the confidence
that therapist-researchers have in their observations can be both
rigorously challenged and bolstered. We present ways of undertaking this
triadic approach to inquiry and sensemaking along with a conceptual tool
from the presenters' work, "The Y of the How," will be offered as one way
this approach to clinical research can be accomplished.

This move to the applied fields has brought with it another interesting
trend in qualitative research, namely the practitioner-as-researcher. When
these researching practitioners such as computer programmers, librarians,
nurses, therapists, physicians, and managers study their computer
applications, service delivery, care-giving, counseling, consulting, or
leadership, they are faced with a challenge their non-practitioner
researching colleagues can avoid. Whereas all researchers have to deal
with questions of time, money, approval, and access,
practitioners-as-researchers also have to come to grips with how they are
going to manage their previously acquired knowledge in their soon-to-be
area of research. With this all of this pre-inquiry familiarization with
their subject manner, how will these researching practitioners
conceptualize, conduct, and evaluate their qualitative research projects
in light of their already knowing too much? In other words, how can
practitioners-as-researchers build upon their practice knowledge without
being totally overwhelmed by it?

In this paper, we will discuss this potentially problematic situation
and demonstrate how researching practitioners can make sense of their
practice knowledge, manage it, and utilize it as a resource in their
qualitative inquiries. In our presentation we will focus on one applied
field, psychotherapy, and share our development of a sensemaking approach
to the conduct of clinical qualitative research.

4. The focus of the qualitative inquiry is on evaluating
processes in an organization and assisting stakeholders in creating change
in their organization (e.g., Brown & Kreps,
1993; Kreps, 1989; Schein, 1987).

In this paper, we want to concentrate on the second of
these three conditions--the therapist-as-researcher--and to discuss some
of the challenges involved in clinical projects in which the
therapist-researcher is already familiar with the phenomenon to be
studied. As discussed above, this "knowing-before-hand" presents the
researching therapist with both some interesting resources and some
perplexing problems. For instance, how can researching therapists take
advantage of the rich experiences already created from their experiences
in the field? At the same time, how can these experience-rich therapist
researchers challenge their pre-existing notions of the phenomenon to be
studied and fairly use their research time as an opportunity re-search the
other anew?

This process is especially challenging for clinicians who study
phenomenon or situations with which they already have some familiarity.
For example, clinicians who study their own or others' therapeutic work
for research, model building, and/or supervision purposes. Instead of the
ahistorical posture of grounded theory (Glaser
& Strauss, 1967), where the researchers are new to the clinical
territory to be studied, reflective practicing clinicians must begin with
their own understandings which have been constructed through their
previous exposures to the "field." This is both an advantage and a
disadvantage for the therapist-as-researcher. On the advantage side,
clinicians who study familiar territories have already gained valuable
access to the field, which can be a major stumbling block to studies. They
also have a good start on gaining a feel for the phenomenon. The
disadvantages can be summed up by the saying, "A little knowledge can be a
dangerous thing!" Because clinicians may have preconceived notions
regarding the phenomenon to be studied, this may lead to a premature
narrowing of focus or, worse yet, to a view of the phenomenon which is
replete with blind spots from this already-in-place lens.

Many non-clinician researchers use qualitative methods like grounded
theory (Glaser & Strauss, 1967) because
there is a "tabula rasa" quality to this initial foray into the "unknown."
Conversely, researching clinicians must face their previous constructions
(i.e., sensemaking from experience), create methods which allow for
deconstruction (i.e., sensemaking challenged), and then work towards
building reconstructions (i.e., sensemaking remade) (Dervin, 1992; Duffy, 1995; Shields & Dervin, 1993; Weick, 1995). In this manner, that confidence
therapist-researchers have in their observations can be both rigorously
challenged and bolstered.

One way for researching therapists to make their assumptions more overt
and potentially more useful is to reflect upon their sensemaking
activities rigorous asking of questions to themselves. Just as therapists'
questions to their clients help to shape the talk in clinical sessions,
therapists' questioning of themselves as therapists-turned-researchers
help to shape the method in of study. We call this part of the
conceptualization process, "The Y of the How: Sensemaking in Qualitative
Inquiry." When a "Y" is drawn, one can see that three different areas have
been created--all connected, yet separate spaces. The three spaces created
by drawing the "Y" represent the three foci of the researcher's
sensemaking activities in a qualitative research project.

One area of focus is the therapists' own sense of the phenomenon in
question. For clinicians this usually comes from reflection on their
previous experiences with the phenomenon in their clinical education,
practice, and training. The second area is the therapists' sense of the
sensemaking attempts others have made regarding this and related
phenomenon. This area consists of the writings and comments of other
researchers, practitioners, and/or any other person who has had some
involvement with the phenomenon to be studied. The third area of focus for
the therapists' sensemaking process is the study itself. As researching
therapists begin to make sense of the data which is generated from the
study, they will then carefully juxtapose these new sensemakings of theirs
with those sensemakings they had previously constructed of the phenomenon
in the "self-reflexive" and the "reflections on the others" phases of the
process.

By examining these sensemakings, each in context with the others,
researching therapists will see the relationships between them. Questions
such as, "Are the different notions you have had about the phenomenon
beginning to cohere? Are they beginning to disagree with each other? Are
you gaining confidence in any one of them? Are your thoughts from one area
of sensemaking beginning to change based upon your sensemakings in
another?" can all be asked in this "bringing to light" process of the
sensemaking enterprise in clinical qualitative research.

The ways in which therapists-as-researchers go about making sense of
their own sensemaking is so crucial to the eventual success, or lack
thereof, of a particular project. Therapists must bring forth their own
ideas, hunches, biases, blind spots, and questions, examine them closely,
and challenge them at the same time.

Concurrently, therapists-as-researchers must explore the sensemakings
of others who have also traveled this territory. In combination with their
own experiences of the phenomenon, which have been heightened through a
systematic, reflective process, researching therapists must weave the
ideas of others to form a focus into the phenomenon in question. In turn,
this concentration of their senses will lead therapist researchers to
construct their own understanding of the phenomenon with which they have
been researching. All the time in this unfolding of their sensemaking,
researching therapists will have allowed themselves to challenge the
constructions of which they can become all too fond.

The scientific folks call this "falsification," but we see it more
along the lines of a construction-deconstruction-reconstruction process
leading to confidence building on the part of the researcher. The study
undertaken is the one in which the greatest amount of confidence is
placed. Following from this, the sensemaking account which finds it way
into the project's re-porting is the one with which the researcher is the
most confident of "projecting" into the ongoing conversation of clinical
researchers and practitioners.

And, from where does this confidence come? As with artists and
performers, it comes from the repetition of rituals and the practice of
performance. It also takes shape through the steady flow of reviewers'
praise and criticism. For researchers this can come from others (e.g.,
researchers, practitioners, the participants in the study) including
themselves when they don their critics' hats.

At the same time, this sensemaking process can lead to a shaking of the
researching therapists' confidences in what they think they know. A new
study in a researching therapists' area of focus which contradicts their
findings, a new clinical session they experience which reveals new
insights on the phenomenon, the juxtaposition of a new metaphor which
allows them to see the data in a novel way are all possibilities which
must be embraced by researching therapists in this mode of inquiry. Any
and all of these can lead to a deconstruction of the
therapist-researchers' understandings and a lowering of their confidence.
Of course, each of these revelations must also be scrutinized and
challenged in its own right, but their coming to light must be dealt with
and woven into the sensemaking process. It is the responsibility of the
researching therapist to clearly delineate these reckonings when
recounting their study (Chenail, 1994;
Constas, 1992). Relating these
challenges to therapists-as-researchers' sensemaking helps give a sense of
trustworthiness to their accounts of the research. An openness to the
telling of the "bumpiness" inherent in this winding road to understanding
will be both truthful and persuasive to yourself and to your readers.
Such a narrative tells the way these things happen and the tale will be
readily recognizable for anyone else who travels along this research
trail.

With all of this confidence building and shaking, what the researching
therapist can legitimately say is, "This is how I make sense of this
phenomenon now." Once that is said, the process begins again as the
therapists-researchers re-search and seek to build upon those theories
and/or to deconstruct them. As Jack Horner, the eminent paleontologist,
says, "If anyone refutes one of my theories, I would like for that person
to be me!" We think we would have to agree with him. It takes courage to
do such a thing, but it is also the essence of what we do as
researchers.

Equally important in qualitative research, especially when conducting
case studies, is a N of 1, or where there are limited cases to study,
researching therapists have to maximize the number of observations or
"O's" they make. Quantitative researchers gain confidence in their numbers
(of cases). Qualitative researchers also gain confidence with their
numbers (of observations). Of course, qualitative researchers also gain
confidence by building qualitative differences too. They can take
qualitatively different perspectives on the same case. They can reflect on
one observation at one time and use that new sensemaking perspective to
look for something qualitatively different in the phenomenon from what had
been the focus of study before.

Another area to explore in these studies are the multiple sources of
data from the one case. For example, researching therapists can collect
and study documents (e.g., case notes, journals, court papers), generate
field notes from participant observations while observing the case unfold,
interview participants and study the tapes and transcripts, conduct
discourse analyses from tapes of the actual mediation sessions, and so
forth. In each of these data bases, therapists-as-researchers can conduct
different analyses, involve different analysts, juxtapose different
metaphors, and so forth. All of these acts come together with one
purpose--to construct an answer to some question and to challenge that
construction so that eventually, therapists-researchers come with a
narrative they can accept with a certain level of confidence, for now.

Techniques like member checking, audit trails, and journal keeping can
also be used as challenges to these sensemakings of the phenomenon at hand
in that their use may produce contrary or variant interpretations or
descriptions with which reflective researching therapists must contend.
Conversely, the use of these techniques can also serve as a confidence
builder in the sensemaking process if they present interpretations and
descriptions which give support to or cohere with the previous renderings
of the data.

In this way of thinking, computerized qualitative data analysis
programs can also produce the same effect in a qualitative research study
as the audit trails, member checks, and journal keeping (Weitzman & Miles, 1994). The packages which
aid in hypothesis testing can be sources of confidence building or
confidence shaking depending on their relationship with the previous
sensemakings of the data. One can almost hear this phenomenon in the
language of those researchers who use these programs in their work. When
they say something along the lines of "The results of this analysis do not
support my hypothesis regarding this phenomenon," one can pick up on how
the researcher's confidence has been shaken. Conversely, a statement like
"My theory was supported by the results of the computerized qualitative
data analysis," is brimming with the confidence which can come from
"third-party" validation.

Lastly, we feel it is important to not save this whole
constructing/deconstructing process for the last phase of the research
process. We know some folks who approach it that way. For example,
researchers build these wonderful constructions of what the data are
telling them. They have spent countless hours honing and crafting this
wonderful edifice of descriptions and interpretations. Then, sometimes
just before a deadline must be met, they bring this structure of
descriptions and interpretations before "an other," be it a dissertation
committee member or a co-participant in the project, and ask them what
they think about this fine building. That takes a tremendous amount of
courage on both parties' parts. For readers, they must be comfortable
enough to disagree with the researcher, if that is the case. Researchers
on the other hand, must be comfortable enough with the possibility of
having to take apart the whole wonderful building if the other does not
agree that its structure is sound.

Instead of this "wait til the very end" scenario, all researchers
should build this stream of difference into their constructing process as
an ongoing occurrence. In the case of therapist-researchers, they can do
this by traveling around the "Y" in fairly regular intervals. In the
making sense of others area, therapists-as-researchers can revisit the
ideas of others via member checking, literature reviews, Internet forays
into online discussion groups, and World Wide Web surfings. With the
making sense of the study at hand space, researching therapists can
revisit the "field" and review the data they have collected and/or
generate new data for new viewings. And, in the making sense of their own
understandings realm, they can revisit themselves by writing new journal
entries and by re-reading old ones, They can also take stock in the
deficiencies and exuberances in their interpretations and descriptions, by
attempting to "see" their blind spots and to "hear" their deafness.

If sufficient time is spent at the "Y" and the accounts of this are
carefully relayed in writings and presentations, both the researching
therapists and their audiences will have greater confidence in the
research "findings" and constructions. The therapists-as-researchers and
their colleagues will also find the work to be more trustworthy because
the researching therapists will have had the integrity to open up their
private observations for public scrutiny. They will have taken every
opportunity to present the data with the descriptions of that data and
they will also have included evidence of the "backstage" work which went
into the "final" production the colleagues are now seeing in the
presentations and are now reading in papers.

Despite the complexity, therapists-as-researchers can create
informative and trustworthy research projects where they can be confident,
if they keep one simple question in mind, "What can I do in my research
that will afford me another opportunity to build my confidence regarding
my sensemaking of this phenomenon and will also present me with another
chance to shake my confidence regarding my understanding of this same
phenomenon?" In this fashion, qualitative research becomes an unfolding
dialectic of building and shaking confidence until researchers reach a
level of trust in their sensemaking of the phenomenon in question that
they are able to produce a study. At that point, they and others will then
set about the process all over again. It will also be at that moment that
they will begin to realize why this process is called "re-search" and not
just "search" after all.